Medication Therapy Management (MTM) Program

We work with our members to help them make informed choices about their health care and medications. Our Medication Therapy Management program is designed for members with Medicare prescription drug coverage who have specific health and pharmacy needs.

The MTM program is available to members with 3 or more specific chronic medical conditions (listed below) who are taking 8 or more prescription medications and are expected to spend more than $3,967 per year in 2018 on their prescriptions.

Participants will receive written information on safe, effective drug treatment and how to treat and prevent complications from their medical conditions.

Bone Disease - Arthritis - Osteoporosis

Chronic Heart Disease CHF

Diabetes

Dyslipidemia

Hypertension

MTM program participants also have the opportunity to participate in a FREE personalized phone consultation with a clinical pharmacist. The pharmacist will review your medication history, offer drug safety guidance, and identify ways for you to save money on your prescriptions. It usually takes 15 - 30 minutes, depending on your needs and questions. Following the consultation, the clinical pharmacist will send you a written copy of the recommendations for your records and will share a copy with your doctor.

You are eligible to receive a FREE personalized consultation with a clinical pharmacist through expanded eligibility, even if you don't qualify for the MTM program. The MTM program is not a benefit.

The MTM program provides you with the information and tools to help you make educated health care decisions.

If you meet the qualifications you are automatically enrolled in the MTM Program. You will receive a Welcome Letter and a Phone Call. If you choose not to participate in this voluntary program you must notify us of your decision to be excluded by calling the MTM contact line at 1-800-559-8426, 24 hours a day, 7 days a week, and leave a message on the voicemail system. Messages are retrieved each business day.

For more information on the MTM program, call Customer Care toll-free at 1-877-883-9577 (TTY/TDD 1-800-421-1220) 8 a.m. to 8 p.m., Monday – Friday, Saturday 9:00 a.m. to 1:00 p.m. From October 1 to February 14, representatives will be available seven days a week from 8 a.m. to 8 p.m.

Excellus BlueCross BlueShield contracts with the Federal Government and is an HMO plan and PPO plan with a Medicare contract. Enrollment in Excellus BlueCross BlueShield depends on contract renewal. Submit a complaint about your Medicare plan at www.Medicare.gov or learn about filing a complaint by contacting the Medicare Ombudsman. .